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PubMed2001

Betamethasone alteration of the one-hour glucose challenge test in pregnancy.

OBJECTIVE: To determine if betamethasone administration alters the one-hour (50-g) glucose challenge test (GCT) and, if so, to determine the duration of this effect. STUDY DESIGN: Pregnant women with singleton gestations eligible to receive antenatal betamethasone (24-34 weeks) with no evidence of infection, diabetes mellitus, hepatic or pancreatic disease, betamimetic therapy or prolonged steroid use were invited to participate. Betamethasone (12 mg) was administered intramuscularly upon admission and repeated in 24 hours. After an 8-hour fast, a 50-g GCT was administered 24 hours (day 1) and 72 hours (day 3) after the second betamethasone injection. Plasma glucose samples were drawn one hour after the glucose challenge. Statistical analysis utilized the McNemar exact test. RESULTS: Seven patients, all with normal GCTs 7-10 days outside the study period, were enrolled. Six had abnormal GCT results on day 1 (P = .03). Three had abnormal results on day 3. CONCLUSION: Betamethasone administration results in abnormal one-hour GCTs in pregnant women.

Adult↗

PubMedDate not supplied

Increase in prostaglandin H synthase 2, but not prostaglandin F2alpha synthase mRNA in intrauterine tissues during betamethasone-induced premature labor and spontaneous term labor in sheep.

OBJECTIVE: Prostaglandin F synthase (PGFS) catalyzes reduction of prostaglandin H(2) to PGF2alpha. No information exists on PGFS expression and regulation during pregnancy, either mRNA or protein, in relation to labor in uterine tissues in any species. We characterized PGFS mRNA expression in ovine myometrium, endometrium, maternal and fetal placenta in betamethasone-induced premature labor and spontaneous term labor using our cloned ovine PGFS riboprobe. Prostaglandin H synthase (PGHS) 2 mRNA was evaluated simultaneously as a control whose pregnancy related changes are well known. METHODS: Poly-A or total RNA from fetal placenta, myometrium, and endometrium in control ewes at 143-147 days of gestational age (dGA, TCNL, n = 6), and ewes in spontaneous term labor at 145-147 dGA (STL, n = 6) and endometrium and maternal and fetal placenta in early control ewes not in labor (ECNL, n = 6) and betamethasone induced labor at 128-135 dGA (BL, n = 6) were analyzed for PGHS2 and PGFS mRNA. RESULTS: PGFS mRNA did not change at spontaneous term labor in myometrium, endometrium, and fetal placenta. PGFS mRNA decreased during betamethasone-induced premature labor in endometrium and maternal placenta (P < .05), but remained unchanged in fetal placenta and myometrium. PGHS2 mRNA increased in endometrium, placenta, and myometrium during betamethasone-induced premature labor and spontaneous term labor. CONCLUSION: Increased PGHS2, but not PGFS mRNA was tightly associated with the onset of betamethasone-induced premature labor as well as spontaneous term labor in the endometrium, placenta, and myometrium. Transcription of PGFS mRNA may not be the rate-limiting step in the pathway contributing to increased PGF(2alpha) at labor.

Animals↗

PubMed1992

Effects of betamethasone and thyroid hormone on fetal rat lung maturation in vivo.

We studied the effect of maternal administration at various intervals of betamethasone, triiodothyronine (T3), or both, on fetal rat lung maturation. T3 alone did not enhance choline incorporation to phosphatidylcholine by 20-day fetal lung explants, or morphometric lung maturation. Betamethasone, and betamethasone plus T3, increased both of those parameters over control and T3 values. However, addition of T3 offered no advantage over administration of betamethasone alone. Significant enhancement of morphometric lung maturation was already present after only 24 h of exposure to beta-methasone, or to the combination of hormones. However, choline incorporation to phosphatidylcholine only increased significantly by 36 h of exposure to betamethasone with or without T3.

Animals↗

PubMed2006

Betamethasone affects cerebral expressions of NF-kappaB and cytokines that correlate with pain behavior in a rat model of neuropathy.

The objective of this study was to investigate whether corticosteroids modulate neuropathic pain by altering cerebral expression of nuclear factor-kappa B (NF-kappaB) and specific cytokines. The effects of topical betamethasone on neuropathic pain and cerebral expression of NF-kappaB and cytokines were studied in a rat model of L5 spinal nerve transaction. Behavioral testing was undertaken on days 1, 3, 7, 14, and 21 post-operation using the von Frey and Hargreaves tests. NF-kappaB activation in the brain was investigated by an electrophoretic mobility shift assay (EMSA), and cerebral expressions of tumor necrosis factor-alpha (TNFalpha), interleukin-1beta (IL-1beta), and interleukin-10 (IL-10) were quantified using enzyme-linked immunosorbent assays (ELISA). Spinal nerve transection induced mechanical allodynia and thermal hyperalgesia, which were significantly ameliorated by topical injection of betamethasone around the site of injury. In addition, betamethasone reduced the activation of NF-kappaB and elevation of TNFalpha and IL-1beta, and induced the expression of IL-10 in the brain, all of which correlated with the changes of pain thresholds in rats. The results suggest that topical betamethasone injection inhibits the development and maintenance of neuropathic pain. Betamethasone may act by regulating the expression of NF-kappaB, TNFalpha, IL-1beta and IL-10 in the brain. This study yields new insight into the mechanisms of corticosteroid action in neuropathic pain and may provide a basis for clinical pain control.

Animals↗

PubMed1989

Reduction of mortality, morbidity, and respiratory distress syndrome in infants weighing less than 1,000 grams by treatment with betamethasone and ritodrine.

The efficacy of betamethasone has been questioned in infants of less than 28 week's gestation. From January 1983 to June 1986, 86 infants weighing 600 to 1,000 g were born at our center. Control of labor was attempted with ritodrine in all patients with less than or equal to 5 cm cervical dilation. If control were obtained, betamethasone was given 30 minutes later. Significant differences were found between the 33 infants born after 24 hours of betamethasone and those delivered before in terms of survival 90.1% v 56.6% (P = .001), respiratory distress syndrome 27.2% v 73.6% (P = .0001), and need for intermittent positive pressure ventilation 42.4% v 81.1% (P = .0005). The average hospital stay for beta-treated infants was 82 days v 99 days for nontreated infants. The average exposure to O2 after betamethasone was 12.7 days v 20.2 days, (P = .01), although need for intermittent positive pressure ventilation was similar (23 days) in the two groups. In infants who survived greater than 48 hours, the incidence of patent ductus arteriosus in the beta-group was 18.8% (6/32) v 44.4% (16/36) in the nontreated group (P = .04). Our data suggest that in infants weighing less than 1,000 g, control of labor with ritodrine for a minimum of 24 hours and administration of betamethasone can reduce significantly not only the incidence of respiratory distress syndrome but also mortality and morbidity.

Betamethasone↗

PubMed1979

The antenatal use of betamethasone in the prevention of respiratory distress syndrome: a controlled double-blind study.

One hundred forty-six pregnant women were enrolled in a prospective double-blind study to assess the effectiveness and side-effects of antenatal administration of betamethasone in the prevention of respiratory distress syndrome (RDS) in potentially premature infants. On admission to the study, the women were given, at random, either 12 mg of betamethasone or placebo. The same dose was repeated 24 hours later and then weekly up to 34 weeks of gestation. Gestational age of the infants ranged from 25 to 34 weeks, and birth weights ranged between 730 and 2,650 gm. Statistically significant differences in favor of the infants in the betamethasone group were found in the incidence of RDS, 20.7% in the betamethasone group compared with 59.5% in the control group (P less than .005); in the severity of RDS (P less than .05); and in the death rate (P less than .05). A higher incidence of hypoglycemia was found among infants in the betamethasone group (P less than .05). Prolonged rupture of the membranes played no protective role against RDS, and the incidence of infection was similar in both groups.

Betamethasone↗

PubMed1985

[Chemiluminescence on hypoxic brain--the 2nd report: cerebral protective effect of mannitol, vitamin E and betamethasone].

The effect of vitamin E, betamethasone and mannitol upon a series of pathological free radical reaction within the hypoxic brain tissue was evaluated by chemiluminescence method. The hypoxic brain was induced by arterial hypoxemia (PaO2 17-22 mmHg) with normocapnia (PaCO2 28-38 mm Hg) and normotension (MABP 100-140 mmHg). 4% O2-96% N2 mixed gas was used as the replacement for obtaining lowered PaO2. In the control group high valued chemiluminescence was measured in the hypoxic state and in the early stage of the initial post-hypoxic state. In the groups administered vitamin E, betamethasone, mannitol and combination of them, however, just extra low valued chemiluminescence was detected. Besides to explore the stage on which the drugs act in lipid peroxidation, chemiluminescence spectra was analyzed using the homogenate added the each drug. Intensity peaks of the spectra were around at 480, 520-530, 570, 620-640, 680-700 nm before addition of the drugs. All the intensity peaks diminished after addition of vitamin E and betamethasone, while in case of mannitol, very little decrease of the intensity peaks was revealed. These experimental results indicate as follows. The lowered chemiluminescence value may prove the possibility of vitamin E, betamethasone and mannitol as free radical scavengers or inhibitor of lipid peroxidation. Chemiluminescence spectro-analysis shows that vitamin E and betamethasone act on the break down of lipid hydroperoxide and mannitol act on hydroxy radical in lipid peroxidation.

Animals↗

PubMed1977

[Clinical evaluation on glucocorticoid administration in the neurosurgical patients (the third report)--serial plasma cortisol assay following betamethasone 8 mg intravenous injection (author's transl)].

The effect of betamethasone on plasma cortisol concentrations was studied in 6 healty adult men. Each of them was administered 8 mg of betamethasone in a single intravenous injection. Blood samples were obtained serially for 2 days before the injection of betamethasone and for a week after the injection. Plasma cortisol was measured by competitive protein binding analysis. Before the injection of betamethasone plasma cortisol levels showed the normal diurnal rhythm in all the cases. After the injection plasma cortisol levels decreased rapidly and a mean half life time was about 1.7 hours. The low levels of plasma cortisol under 2 microgram/ml were observed for 48 hours after the injection, and then the diurnal rythm of plasma cortisol reappeared, but the levels of plasma cortisol at this time were still lower than the control levels. Then plasma cortisol levles increased gradually and they returned to the control levels 5 days after the injection. Thus, it was clarified that the suppressive effect of 8 mg or betamethasone on plasma cortisol concentrations lasted at least for 48 hours. From this point of view the time interval or repetitive glucocorticoid administration for the treatment of brain edema will further be studied.

Adult↗

PubMedDate not supplied

Effects of betamethasone on the in vitro and in vivo 2-hydroxylation of biphenyl in the rat.

The in vitro addition of betamethasone to rat liver microsomes caused a concentration-dependent stimulation of biphenyl 2-hydroxylation. At a 100 microM concentration of betamethasone, the formation of 2-hydroxybiphenyl was increased by approximately 4-fold in microsomes from 28-day-old rats and 10-fold in liver microsomes from 5-day-old rats. The steroid had little or no effect on the hydroxylation of biphenyl in the 3- or 4-position except at the highest concentration tested (1 mM), where a 20-30% inhibition was observed. The ip injection of 0.01 to 10 mumol of betamethasone to 5-day-old rats had little or no effect on the total body metabolism of 0.01 to 3.5 mumol of biphenyl-2-3H to 2-hydroxybiphenyl as measured by 3H2O formation. Although betamethasone had no effect on the 2-hydroxylation of biphenyl in the intact rat, this reaction was stimulated 4- to 9-fold by the addition of 100 microM betamethasone to hepatocyte monolayer cultures.

Aging↗

PubMed1983

[The betamethasone test in the diagnosis of placental insufficiency].

A trial to evaluate a functional test of the fetoplacental unit by measuring the extent of suppression of maternal estriol serum levels by glucocorticoids is described. 21 women between the 30th and 40th week of gestation received 4 mg betamethason intravenous injection at 8.30 a.m. Blood samples were collected immediately before betamethason application and at 1.00 p.m., 4.00 p.m., 8 p.m. o'clock and at 8.30 a.m. on the next day. Estriol (E3), cortisol, dehydroepiandrosterone sulfate (DHEA-S) and human placental lactogen (HPL) were determined from serum samples by radioimmunologic methods. Patients were divided into 3 groups: severe placental insufficiency (group I, n = 6) described by growth retardation of the fetus of more than 2 weeks, normal gestations (group II, n = 8) and slight growth retardation (group III, n = 7). After temporary suppression in groups II and III, E3, DHEA-S and cortisol levels showed a significant increase the day after betamethason. In group I an increase of these parameters was observed 2 to 5 days after betamethason. These results show that a low intravenous dosage of betamethason and collection of blood samples for E3 assays in intervals of 12 hours can be used as a functional test of the fetoplacental unit.

Betamethasone↗

PubMed1984

[Effect of a betamethasone-dimethidine-maleate combination on dermatologic diseases. Determination of plasma cortisol levels before, during and after several days' therapy].

The combination of betamethasone and dimetindene maleate (Fenistil Plus) is a new combination of a corticosteroid and an antihistaminic agent. According to the pharmaceutical formula, patients must take three capsules daily, whereby only the morning dose contains betamethasone as well as the antihistaminic. The aim of the study, which was performed on dermatological cases, was to examine the restitution of plasma cortisol concentrations following circadian betamethasone therapy of several days duration, as well as to confirm the clinical effectiveness of the drug combination. The results obtained in the study, carried out in a total of nine Patients suffering from various types of dermatitis, showed that the desired therapeutic effects were achieved. In three patients, plasma cortisol concentrations were found to have returned to normal values within four days after cessation of a ten days treatment. From the above results it may be concluded that permanent adrenocortical suppression is not to be expected in patients treated with betamethasone (0,75 mg) in the morning, for a period of ten days. Furthermore, it may be stated that dimetindene maleate (3 mg/day) in combination with the morning dose of betamethasone proved to be therapeutically effective.

Administration, Oral↗

PubMedDate not supplied

Protective effect of betamethasone on the subendocardial ischemia after the cardiopulmonary bypass.

The experimental and clinical studies on the protective effect of Betamethasone upon the myocardium particularly on the prevention of the subendocardial ischemia after the cardiopulmonary bypass was investigated on the ultrastructural alterations of the epicardium and the endocardium obtained by the transmural left ventricular myocardial biopsy. Pretreatment of Betamethasone, 5 mg/Kg, with single intravenous injection a half to one hour before cardiopulmonary bypass was effective to preserve the myocardial ultrastructure after the anoxic arrest and in the recovery period after restoring the coronary circulation. The intramyocardial gradient of the ultrastructure was diminished by Betamethasone hardly demonstrating the no-reflow phenomenon. Hemodynamic and metabolic changes did not show the significant effectiveness of Betamethasone. It was suspected that Betamethasone stabilized the cell membrane and lysosome and suppressed the interstitial edema in the myocardium during and after anoxic arrest.

Adult↗

PubMed1981

Cognitive and psychosocial development of 4-year-old children whose mothers were treated antenatally with betamethasone.

The present study was part of a larger study investigating the long-term development of children of mothers included in a controlled trial of betamethasone therapy in preterm labor, the purpose was to determine whether there are any benefits or hazards of treatment detectable up to the seventh year of life. The first 318 children of mothers included in the trial because of spontaneous premature labor were selected for study. Of 305 survivors, 258 (84.6%) were included in this phase of the study. Detailed tests of psychological development, together with assessments of psychosocial background, were made during the fifth year. Of the 258 children 144 were in the betamethasone group and 114 were control patients. Despite a heavy weighting of the betamethasone group with more prematurely delivered infants and more boys (resulting from improved perinatal survival of these children associated with betamethasone therapy), no significant differences emerged between the groups in measures of outcome. It was concluded that betamethasone therapy, under the conditions of the original trial, was not hazardous to cognitive development as measured in this study.

Betamethasone↗

PubMed1982

Betamethasone, albuterol, and threatened premature delivery: benefits and risks. Study of 469 pregnancies.

This report details the outcome of pregnancy in 469 patients admitted before 34 weeks' gestation with premature labor with intact membranes (253 patients) or premature rupture of the membranes (PROM) but no labor (216 patients). Betamethasone significantly reduced the incidence of severe respiratory distress syndrome (RDS) both in patients with intact membranes and in those with PROM. PROM had a significant beneficial effect on the incidence of RDS in both groups of patients, those who had received betamethasone and those who had not. Fetal sex did not significantly influence the respiratory response to either PROM or betamethasone administration, except that betamethasone treated female fetuses showed a significantly better response to PROM than similarly treated males. Except in patients with PROM associated with a cervical suture, betamethasone administration did not increase the risk of perinatal or maternal infection.

Albuterol↗

PubMed1981

Incidence of respiratory distress syndrome following antenatal betamethasone: role of sex, type of delivery, and prolonged rupture of membranes.

Premature male infants have a higher incidence of respiratory distress syndrome (RDS) than female infants (male/female = 1.7:1.) With the demonstration that antenatal use of betamethasone significantly reduces the incidence of RDS, a proportional reduction or possibly a complete elimination of the discrepancy between the two sexes might be expected. The role that sex, type of delivery, and prolonged rupture of membranes (PROM) may play in the development of RDS was tested in a prospective study of RDS prevention with betamethasone. A full course of betamethasone, ie, 12 mg, 24 hours apart, was given antenatally to 94 infants of 27 to 34 weeks gestation. The incidence of RDS in male infants was 29.1% vs 8.6% in female infants (P less than .02). The incidence of RDS among male babies delivered by cesarean section (30.3%) or vaginally (29.7%) was not statistically different, nor was there a difference between those with PROM greater than 24 hours (26.9%) and those without PROM (31.8%). The same was true of the incidence of RDS among female infants: cesarean section (14.2%) vs vaginal delivery (6.2%) and PROM greater than 24 hours (8%) vs (9.5%) without PROM. We conclude that: (1) Prevention of RDS with betamethasone is far more effective in female infants. The natural ratio of male/female of 1.7:1 becomes 3.4:1. (2) Once lung maturity has been achieved with betamethasone, the type of delivery plays no role in the development of RDS. (3) PROM does not add extra protection from RDS in the 27- to 34-week gestational age range.

Betamethasone↗

PubMed1980

Effect of betamethasone on mitochondrial oxidative phosphorylation in ischemic canine myocardium.

Hemodynamics and myocardial blood flow were studied in 14 anesthetized open-chest dogs that were subjected to coronary artery occlusion followed by reperfusion. In six dogs, betamethasone was given intravenously 30 minutes before occlusion. During reperfusion, a significant increase in myocardial blood flow in nonischemic tissue was observed in the betamethasone group as compared with control (P less than 0.05). Also, the increase in myocardial blood flow in steroid-treated nonischemic tissues during reperfusion was significantly greater (P less than 0.05) than that measured in ischemic tissues in the same group. However, betamethasone failed to protect mitochondrial respiration from ischemic damage. Respiratory control indices in ischemic tissues were significantly depressed, compared with those in nonischemic tissues, even in betamethasone-treated dogs, and the degree of depression was the same in the ischemic tissues of control and treated dogs. These data suggest that betamethasone was not effective in preserving mitochondrial function in ischemia but that it increased myocardial blood flow in nonischemic tissue.

Animals↗

PubMed1993

Mometasone versus betamethasone creams: a trial in dermatoses.

AIM: To compare the efficacy and safety of mometasone furoate cream 0.1% applied daily versus betamethasone valerate cream 0.1% applied twice daily in a variety of dermatoses. METHODS: A 4 week study was undertaken of patients with at least moderately severe dermatoses as judged by scoring of a target lesion. Weekly global improvement was assessed, as well as change in target lesion scores. Local side effects were noted including observation of atrophy. RESULTS: Fifty eight patients in three centres completed the study, 30 in the betamethasone group and 28 in the mometasone. There was no difference in demographic variables or disease severity in each group or any difference between the three investigator gradings of initial severity. There was a rapid onset of improvement in both groups by day seven (scores being reduced by 72% in the betamethasone group and 65% in the mometasone group). By the fourth week visit there was 90% reduction in the betamethasone group score and 93% in the mometasone. There was no significant difference between the groups. CONCLUSION: Mometasone furoate cream 0.1% applied daily in dermatoses is as effective as betamethasone valerate 0.1% cream. Both creams had rapid onset of action and had no signs of atrophy. Better patient compliance could be expected with the convenience of mometasone cream being applied daily.

Administration, Cutaneous↗

PubMed1997

Comparative efficacy of calcipotriol (MC903) cream and betamethasone 17-valerate cream in the treatment of chronic plaque psoriasis. A randomized, double-blind, parallel group multicentre study. Calcipotriol Study Group.

The efficacy, safety and tolerability of calcipotriol cream was compared with betamethasone 17-valerate cream in the treatment of plaque-type psoriasis in a multicentre double-blind, parallel group study. Patients with stable mild-to-moderate chronic disease were randomized to treatment with either calcipotriol, 50 micrograms/g, in a cream formulation (210 patients) or betamethasone 17-valerate cream, 1 mg/g (211 patients). After a wash-out period of 2 weeks, the treatment was applied twice daily, without occlusion, for 8 weeks or to complete clearing. The severity of psoriasis was assessed using the PASI at baseline and after 4 and 8 weeks treatment. The mean percentage reduction of PASI from baseline to end of treatment was 47.8% in the calcipotriol group and 45.4% in the betamethasone group. The reduction from baseline was highly significant in both groups, but the difference between the groups was not significant. There was a difference in the reduction in thickness of the lesions in favour of calcipotriol. The investigator's as well as the patient's overall assessment of treatment response at end of treatment showed no difference between the two treatment groups. Treatment-related adverse events were more frequent with calcipotriol than betamethasone. Lesional/perilesional irritation was reported in 16% and 9% (P = 0.03), and facial irritation in 10% and 0.5% (P < 0.001), respectively. No change was found in serum levels of calcium. Calcipotriol in a cream formulation was effective, safe, well-tolerated, and equal in effect to betamethasone valerate cream.

Administration, Topical↗